Myocardial infarction is still a global heart health problem with high prevalence. The presence of impaired blood flow and oxygen supply to the heart muscle causes cell death or necrosis. Post myocardial infarction needs attention by looking at the frequent complications of heart failure. According to previous research GLP-1R (Glucagon Like Peptide) Receptor Agonist Exendin-4 is one hyperglycemia drug that has good affinity in protecting post cardiac myocardial infarction. With the addition of polymer polyethylene glycol (PEG) to exendin-4 is expected to increase the absorption of exendin-4 in the body so that it can be a post-myocardial therapy modality with transdermal drug delivery formulation of tip-loaded microneedle arrays with penetrating through skin properties and are practical in their use. This writing aims to determine the activity of cardioprotective PEG-Exendin-4 which is formulated in tip loaded microneedle Array drug delivery system. Writing methods by taking literature such as journals and books published in the last 10 years related to Myocardial Infarction, Exendin-4, Polyethylene glycol (PEG), and microneedle Array. The results show that PGE-Exendin-4 has a high affinity for GLP-1R and has the effect of enhancing the contractile function of the heart, decreasing fibroblasts and ventricular hypertrophy in preventing vectoric remodeling as well as initiating angiogenesis. Needs further research to find out the exact dose of PGE-Exendin4.

Suicide is one of the leading causes of death globally for all ages, and every year nearly one million people die from it. Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind. The only management in suicide is to prevent it from happening by controlling the suicide ideation and behavior before one lead to successfully attempting suicide. Currently, suicide ideation and behavioral management focused around psychotherapies, psychopharmacology, and even electro convulsion therapy (ECT). These managements is not well applicable in people with acute state of suicidal. Pharmacological strategies that have rapid action of antidepressant effects within hours would therefore have an enormous impact on public health. Recently a lot of research shows the potency of thyrotrophin releasing hormone (TRH) as a rapid acting anti-suicidal. TRH act by attaching to thyrotropin receptors in the brain and inhibit the suicidal behavior. The rapidity of ketamine’s antidepressant effects has sparked interest in its potential as an anti-suicide treatment and its action in increasing synthesis and release of TRH will make TRH and ketamine a great beneficial combination. Intranasal administration (nasal spray) provide a great access to pass through blood-brain barrier and to the brain. Therefore the combination of TRH and ketamine prepared in an easily used from, which is intranasal spray, is predicted to achieve quick anti-suicidal effect and is hoped to serve an immediate management as prevention in acute suicidal state.